Provider Demographics
NPI:1891325429
Name:LUESO CLAPES, INDIRA
Entity Type:Individual
Prefix:
First Name:INDIRA
Middle Name:
Last Name:LUESO CLAPES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17041 SW 119TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33177-2115
Mailing Address - Country:US
Mailing Address - Phone:786-915-7007
Mailing Address - Fax:
Practice Address - Street 1:13500 SW 88TH ST UNIT 285
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-1515
Practice Address - Country:US
Practice Address - Phone:786-409-2646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-23
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior AnalystGroup - Single Specialty